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Humeral shaft fracture

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https://www.readbyqxmd.com/read/28916133/a-modified-deltoid-splitting-approach-with-axillary-nerve-bundle-mobilization-for-proximal-humeral-fracture-fixation
#1
Young Ho Shin, Young Ho Lee, Ho Sung Choi, Min Bom Kim, Sung Hee Pyo, Goo Hyun Baek
INTRODUCTION: The deltopectoral and the deltoid splitting approach are commonly used for the treatment of proximal humeral fractures. While the deltopectoral approach requires massive soft tissue devascularization, the deltoid splitting approach needs an additional skipped incision to avoid axillary nerve injury. The purpose of this study was to describe a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization in the treatment of proximal humeral fractures and to assess its radiologic and clinical outcomes...
September 8, 2017: Injury
https://www.readbyqxmd.com/read/28861208/retrograde-intramedullary-nailing-for-humerus-fracture-in-a-supine-position-performing-an-unfamiliar-procedure-in-a-familiar-position
#2
Jin Woong Yi, Jae Sin Lee, Hyung Jun Cho
Intramedullary (IM) nailing for humeral shaft fracture has provided excellent outcomes in terms of fracture biology and cosmetic appearance because of the relatively small incision involved. However, antegrade nailing causes issues such as iatrogenic rotator cuff injury. Retrograde nail fixation method could avoid cuff injury, but has shortcomings such as the need for the prone or lateral decubitus position during surgery. We report that the retrograde IM nail fixation technique performed in a supine position and some ancillary techniques for minimizing scars or complications can provide the advantages of both retrograde nailing and supine position during surgery...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28852327/dynamic-fixation-of-humeral-shaft-fractures-using-active-locking-plates-a-prospective-observational-study
#3
Steven M Madey, Stanley Tsai, Daniel C Fitzpatrick, Kathleen Earley, Michael Lutsch, Michael Bottlang
BACKGROUND: Rigid locked plating constructs can suppress fracture healing by inhibiting interfragmentary motion required to stimulate natural bone healing by callus formation. Dynamic fixation with active locking plates reduces construct stiffness, enables controlled interfragmentary motion, and has been shown to induce faster and stronger bone healing in vivo compared to rigid locking plates. This prospective observational study represents the first clinical use of active locking plates...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28828634/potential-risk-factors-for-birth-fractures-a-case-control-study
#4
Thanase Ariyawatkul, Kitti Worawuthangkul, Chatupon Chotigavanichaya, Kamolporn Kaewpornsawan, Ornusa Chalayon, Perajit Eamsobhana
INTRODUCTION AND HYPOTHESIS: Birth fractures are uncommon but remain a concern among obstetricians. Although such fractures usually heal without long-term sequelae, some are associated with lifelong disabilities, such as brachial plexus injuries. The purpose of this study was primarily to investigate risk factors related to birth fractures. METHODS: This study comprised newborns delivered at our institute between 2003 and 2013. All 46 birth fractures were reviewed and compared with 223 randomly selected normal neonates...
August 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28802426/comparison-between-antegrade-intramedullary-nailing-imn-open-reduction-plate-osteosynthesis-orpo-and-minimally-invasive-plate-osteosynthesis-mipo-in-treatment-of-humerus-diaphyseal-fractures
#5
Vidisha Sunil Kulkarni, Madhura Sujay Kulkarni, Govind Shivram Kulkarni, Vaibhav Goyal, Milind Govind Kulkarni
INTRODUCTION: The three currently used methods of treatment: namely open reduction plate osteosynthesis (ORPO), Minimally invasive plate osteosynthesis (MIPO), antegrade intramedullary nailing(IMN) are all reported as satisfactory procedures for treatment of humeral shaft fractures. However none of the published reports have a comparison of superiority of one procedure over the other. We evaluated the clinical, radiological and functional outcome of the three procedures. MATERIALS AND METHODS: We studied adult patients with humerus shaft fractures over a period of 2 years from May 2014 to May 2016 in a level 1 trauma center...
August 2017: Injury
https://www.readbyqxmd.com/read/28795436/anatomic-characterization-of-the-humeral-nutrient-artery-application-to-fracture-and-surgery-of-the-humerus
#6
Koichiro Ichimura, Shota Kinose, Yuto Kawasaki, Taro Okamura, Kota Kato, Tatsuo Sakai
Anatomic characterization of the humeral nutrient artery varies among the several textbooks on human anatomy. To clarify the anatomic characteristics of the humeral nutrient artery, we reexamined its origin and course by cadaveric dissection. In typical cases, one prominent nutrient foramen was situated on the anteromedial surface of the humeral shaft, and the nutrient canal distally penetrated the cortical bone layer. The humeral nutrient artery originated from the brachial artery below the level of the nutrient foramen as a short ascending branch...
August 10, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28790538/comparison-of-plate-nail-and-external-fixation-in-the-management-of-diaphyseal-fractures-of-the-humerus
#7
Michele Bisaccia, Luigi Meccariello, Giuseppe Rinonapoli, Giuseppe Rollo, Marco Pellegrino, Andrea Schiavone, Cristina Ibáñez Vicente, Pellegrino Ferrara, Marco Filipponi, Auro Caraffa
INTRODUCTION: Humeral shaft fractures are quite common in orthopedics and represent 1-3% of adult fractures. The surgical treatment is the a better choice in order to obtain a reduction and stable alignment and to prevent the complications. The goal of this study was to compare the three techniques (IMN, LCP and EF) in the treatment of diaphyseal fractures of the humerus in the adult patient. MATERIALS AND METHODS: We examined 79 patients with diaphyseal fractures of the humerus...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28780727/interventions-for-humeral-shaft-fractures-mixed-treatment-comparisons-of-clinical-trials
#8
Y Zhao, J Wang, W Yao, Q Cai, Y Wang, W Yuan, S Gao
We designed a study to compare the efficacy of five main therapeutic options, including external fixation, open reduction and plate osteosynthesis (ORPO), minimally invasive plate osteosynthesis (MIPO), dynamic compression plate (DCP), and intramedullary nail (IMN) in treating humeral shaft fractures. Our results indicated that MIPO and IMN were recommended as the optimal treatments for clinical use. PURPOSE: Nowadays, five main therapeutic options are used in treating humeral shaft fractures: external fixation, open reduction and plate osteosynthesis (ORPO), minimally invasive plate osteosynthesis (MIPO), dynamic compression plate (DCP), and intramedullary nail (IMN)...
August 5, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28770512/immediate-intensive-mobilization-compared-with-immediate-conventional-mobilization-for-the-impacted-osteoporotic-conservatively-treated-proximal-humeral-fracture-a-randomized-controlled-trial
#9
S Carbone, C Razzano, P Albino, R Mezzoprete
PURPOSE: To select in a 2-year survey of proximal humerus fractures accessing the emergency department, a population of osteoporotic stable impacted fractures and to randomize them into two groups, one with an immediate intensive mobilization program and the other with an immediate conventional mobilization program. METHODS: In emergency department, patients with clinical signs of shoulder girdle fracture were submitted to standard X-ray examination and CT scan...
August 2, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28760131/atypical-injury-of-radial-nerve-after-humeral-shaft-fracture
#10
Murat Yeşil, Özal Özcan, Ömer Ali Kaya, Sadık Emre Erginoğlu
As general opinion, conservative treatment is usually suggested for closed humeral shaft fractures with radial nerve palsy; however, some authors advocate early surgical exploration, particularly for spiral fractures of the humerus accompanied with radial nerve palsy. In this article, we present a case of radial nerve palsy after fracture of the proximal-middle third of humeral shaft. A surgical exploration of the nerve revealed that the sharp tip of the bony fragment at fracture site was penetrated into the nerve and separated the nerve as two bands, almost like a ″buttonhole″ injury...
August 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28741325/continuous-pain-and-swelling-after-humerus-fracture-in-an-86-years-old-woman
#11
M Herrera-Pérez, J Boluda-Mengod, R Muñoz-Ortus, M J Gutiérrez-Morales, J Pais-Brito
Metastases to bone are the most frequent cause of destructive lesions to the skeleton in adults . The tumours that are most likely to metastasize to bone are prostate (32%), breast (22%), kidney (16%), lung and thyroid. The typical distribution of metastatic lesions are to the spine, ribs, pelvis, and proximal limb girdles. The humerus is the second most common site for long bone metastases, behind only the femur in its frequency of involvement . It represents the 20% of all bony metastases. We present a clinical case of an 86 yo woman with a previous diagnosis of myofibroblastic sarcoma of the maxillaris who suffers a pathological fracture of the humeral shaft secondary to metastasis and was misdiagnosed and treated for a typical humeral fracture using and intramedullary pinning (Hackethal technique), producing the progression of the disease within the humeral shaft...
January 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28735839/epidemiology-of-proximal-humeral-fractures-a-detailed-survey-of-711-patients-in-a-metropolitan-area
#12
Daniele Passaretti, Vittorio Candela, Pasquale Sessa, Stefano Gumina
BACKGROUND: Literature lacks data concerning several epidemiologic aspects of proximal humeral fractures (PHFs). METHODS: This retrospective study included 711 consecutive patients (209 men, 502 women) who sustained a PHF in the last 3 years. Participants were divided into 2 groups, adults and children. Data regarding age, sex, date, and fracture side were collected. According to the mechanism of injury, we arbitrarily distinguished 7 subgroups. PHFs were classified according to the head-greater-lesser-shaft (HGLS)-Hertel classification and to the Salter-Harris classification using x-ray and computed tomography imaging...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28708781/fracture-site-mobility-at-six-weeks-following-humeral-shaft-fracture-predicts-nonunion-without-surgery
#13
Adam S Driesman, Nina Fisher, Raj Karia, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the presence of fracture site gross motion on physical examination to predict humeral shaft fracture progression to nonunion in patients managed non-operatively. DESIGN: Retrospective cohort study SETTING:: Single trauma level 1 institutional center PATIENTS:: Eighty-four consecutive patients undergoing non-operative treatment of a diaphyseal humeral shaft fracture were identified. The average age of the population was 48.3 years and 50% of the cohort was male...
July 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697085/humeral-shaft-fracture-intramedullary-nailing
#14
Sanjit R Konda, Hesham Saleh, Nina Fisher, Kenneth A Egol
INTRODUCTION: This video demonstrates the technique of intramedullary nailing for a humeral shaft fracture. METHODS: The patient is a 30-year-old man who sustained a gunshot wound to his right arm. The patient was indicated for humeral nailing given the comminuted nature of the diaphysis and to allow for minimal skin incisions. Other relative indications include soft-tissue compromise about the arm precluding a large surgical exposure. RESULTS: This video presents a case of a comminuted humeral shaft fracture treated with an intramedullary nail...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28694341/open-reduction-and-internal-fixation-of-humeral-shaft-fractures-versus-conservative-treatment-with-a-functional-brace-a-study-protocol-of-a-randomised-controlled-trial-embedded-in-a-cohort
#15
Lasse Rämö, Simo Taimela, Vesa Lepola, Antti Malmivaara, Tuomas Lähdeoja, Mika Paavola
INTRODUCTION: Humeral shaft fractures represent 1%-3% of all fractures and 20% of humeral fractures in adults. The treatment of these fractures is mainly conservative and operative treatment is usually reserved for specific circumstances. To date, no randomised controlled trial (RCT) has compared operative treatment of humeral shaft fractures with conservative treatment. METHODS AND ANALYSIS: We will conduct an RCT to compare the effectiveness and cost-effectiveness of surgical and conservative treatment of humeral shaft fractures...
July 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28667397/delayed-union-of-humeral-shaft-fractures-comparison-of-autograft-with-and-without-platelet-rich-plasma-treatment-a-randomized-single-blinded-clinical-trial
#16
Carlos Acosta-Olivo, Abiel Garza-Borjon, Mario Simental-Mendia, Felix Vilchez-Cavazos, Yadira Tamez-Mata, Victor Peña-Martinez
INTRODUCTION: Despite an adequate orthopedic treatment with functional bracing, some patients develop a delayed union in humeral shaft fractures. The objective of the present study was to determine the bone consolidation time among patients with delayed union of diaphyseal humeral fractures who were managed with locking compression plate (LCP) fixation combined with an iliac crest autograft using platelet-rich plasma (PRP) as a co-adjuvant. MATERIALS AND METHODS: This study was a controlled, randomized, experimental, longitudinal, comparative, prospective, blind clinical trial...
June 30, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28659054/self-reducing-proximal-humerus-fractures
#17
Christopher Fang, Ernest Beng Kee Kwek
BACKGROUND: Proximal humeral fractures are common in the elderly and can present with multiple fracture configurations. Our case series describes a three-part valgus-impacted fracture pattern of the proximal humerus that underwent spontaneous reduction by nonsurgical management with good functional outcomes. METHODS: Seven patients who sustained low-energy three-part valgus-impacted fractures of the proximal humerus were studied. We retrospectively reviewed serial anteroposterior radiographs of each patient taken as part of routine follow-up...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#18
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28560796/postoperative-evaluation-of-reduction-loss-in-proximal-humeral-fractures-a-comparison-of-plain-radiographs-and-computed-tomography
#19
Xiao-Yang Jia, Yan-Xi Chen, Min-Fei Qiang, Kun Zhang, Hao-Bo Li, Yu-Chen Jiang, Yi-Jie Zhang
OBJECTIVE: To compare postoperative CT images with plain radiographs for measuring prognostic factors of reduction loss of fractures of the proximal part of the humerus. METHODS: A total of 65 patients who sustained fractures of the proximal humerus treated with locking plates from June 2012 to October 2015 were retrospectively analyzed. There were 24 men and 41 women, with a mean age of 60.0 years (range, 22-76 years). According to the Neer classification system of proximal humeral fracture, there were 26 two-part, 27 three-part and 12 four-part fractures of the proximal part of the humerus, and all fractures were treated with open reduction and internal fixation (ORIF) using locked plating...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28540999/do-cerclage-cables-delay-the-time-to-bone-union-in-patients-with-an-unstable-humeral-shaft-fracture-treated-with-intramedullary-nails
#20
Kyeong Jin Han, Doo Hyung Lee, Joon Young Bang
PURPOSE: To evaluate the time to bone union after open reduction and internal fixation with cerclage cables followed by intramedullary nailing (IMN) for unstable humeral shaft fractures. MATERIALS AND METHODS: Patients with a humeral shaft fracture treated by IMN were enrolled. One group of patients was treated via open reduction and internal fixation with cables followed by IMN (cable group; n=32), while the other group was treated with a conventional closed IMN (non-cable group; n=64)...
July 2017: Yonsei Medical Journal
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